70 Erythema dyschromicum perstans Christine Soon and John Berth-Jones Evidence Levels: A Double-blind study B Clinical trial ≥ 20 subjects C Clinical trial < 20 subjects D Series ≥ 5 subjects E Anecdotal case reports Erythema dyschromicum perstans (EDP) is an acquired, generalized dermal hypermelanosis of unknown etiology. Clinically it presents as asymptomatic, ashen-gray-blue macules of varying sizes, most commonly on the trunk and proximal extremities. Variable components include erythema and papulation. It has been reported most frequently in dark-skinned Latin-American people, although all racial groups can be affected. EDP has similarities to lichen planus pigmentosus and the ‘ashy dermatosis’ of Ramirez, although the precise relationship of these conditions has yet to be established. Management strategy No controlled trials have been reported. Although EDP may persist for many years, there have been reports of spontaneous resolution. Camouflage creams can be prescribed for cosmetic purposes. The treatments discussed below have also been tried, with varying success. Treatments that are reportedly ineffective include sun protection, peeling lotions, antibiotics, topical hydroquinone, topical corticosteroid therapy, antimalarials, and griseofulvin. Specific investigations Biopsy There is vacuolar degeneration of the basal layer associated with pigmentary incontinence. Dermal vessels are surrounded with an infiltrate of lymphocytes and histiocytes, and there are many melanophages present. EDP may need to be differentiated from the late stage of pinta. Dark-field examination and serological tests for syphilis should be carried out to exclude this treponematosis in suspected cases. Idiopathic eruptive macular pigmentation is a similar condition. Histology demonstrates that the pigment is located in the basal layer of the epidermis, and the lichenoid inflammation characteristic of EDP is not present. Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window) Related Related posts: Discoid lupus erythematosus Mucoceles Tinea capitis Necrolytic migratory erythema Nevoid basal cell carcinoma syndrome Rocky Mountain spotted fever and other rickettsial infections Stay updated, free articles. Join our Telegram channel Join Tags: Treatment of Skin Disease Comprehensive Therapeutic Strategies Aug 7, 2016 | Posted by admin in Dermatology | Comments Off on Erythema dyschromicum perstans Full access? Get Clinical Tree
70 Erythema dyschromicum perstans Christine Soon and John Berth-Jones Evidence Levels: A Double-blind study B Clinical trial ≥ 20 subjects C Clinical trial < 20 subjects D Series ≥ 5 subjects E Anecdotal case reports Erythema dyschromicum perstans (EDP) is an acquired, generalized dermal hypermelanosis of unknown etiology. Clinically it presents as asymptomatic, ashen-gray-blue macules of varying sizes, most commonly on the trunk and proximal extremities. Variable components include erythema and papulation. It has been reported most frequently in dark-skinned Latin-American people, although all racial groups can be affected. EDP has similarities to lichen planus pigmentosus and the ‘ashy dermatosis’ of Ramirez, although the precise relationship of these conditions has yet to be established. Management strategy No controlled trials have been reported. Although EDP may persist for many years, there have been reports of spontaneous resolution. Camouflage creams can be prescribed for cosmetic purposes. The treatments discussed below have also been tried, with varying success. Treatments that are reportedly ineffective include sun protection, peeling lotions, antibiotics, topical hydroquinone, topical corticosteroid therapy, antimalarials, and griseofulvin. Specific investigations Biopsy There is vacuolar degeneration of the basal layer associated with pigmentary incontinence. Dermal vessels are surrounded with an infiltrate of lymphocytes and histiocytes, and there are many melanophages present. EDP may need to be differentiated from the late stage of pinta. Dark-field examination and serological tests for syphilis should be carried out to exclude this treponematosis in suspected cases. Idiopathic eruptive macular pigmentation is a similar condition. Histology demonstrates that the pigment is located in the basal layer of the epidermis, and the lichenoid inflammation characteristic of EDP is not present. Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window) Related Related posts: Discoid lupus erythematosus Mucoceles Tinea capitis Necrolytic migratory erythema Nevoid basal cell carcinoma syndrome Rocky Mountain spotted fever and other rickettsial infections Stay updated, free articles. Join our Telegram channel Join
